are there any contraindications to nicotine replacement

Precautions

There are very few absolute contraindications to the use of NRT. In rare and specific clinical situations nicotine is strongly contraindicated through either patient tobacco use or nicotine replacement therapy. More commonly, relative contraindications may occur which should be considered in comparison

Are there any contraindications to nicotine replacement?

Nicotine nasal spray. The nicotine in the spray is rapidly absorbed into the bloodstream from the nose. This form of NRT closely mimics the rapid increase in nicotine level that you get from smoking cigarettes. This may help to relieve sudden surges of craving.

What is the best nicotine replacement therapy?

• Using a nicotine medicine will not cause cancer like smoking.
• Using a nicotine medicine will not cause lung disease like smoking.
• Using a nicotine medicine is much less likely to cause heart disease than continued smoking.
• If you continue to smoke instead of using NRT, you will still be exposed to the hundreds of harmful chemicals in cigarette smoke. ...

How safe are nicotine replacements?

Nicotine replacement therapies actually give you small amounts of nicotine through a product like gum or a skin patch. While you’ll continue to get some nicotine in your system, you won’t be exposed to any of the other harmful chemicals that are found in tobacco. Nicotine replacement won’t help with any emotional connection you may have to smoking.

Are nicotine replacement products harmful?

Who should not use Nicorette?

Before using nicotine gum, tell your doctor if you have or have ever had a heart attack, heart disease, irregular heart rate, ulcers, diabetes, or high blood pressure not controlled by medication; if you are under 18 years of age; or if you are on a sodium-restricted diet.

What medications interact with nicotine patch?

There may be an interaction between nicotine patches and any of the following:acetaminophen.adenosine.benzodiazepines (e.g., oxazepam)caffeine.furosemide.imipramine.insulin.labetalol.More items...

What is a contraindication for the transdermal patch?

Transdermal drug delivery is contraindicated in patients with[10]: Allergies to the active substance utilized in the transdermal patch. Essential fatty acid deficiency. Dry skin.

Which one of the following is a contraindication for the nicotine lozenge?

You should not chew or swallow the lozenge. Hypersensitivity to any of components of the lozenge. Nicorette Cools 2 mg Lozenge is contraindicated in children under the age of 12 years....Hide table of contents.Body SystemIncidenceReported adverse event (Preferred Term)Gastrointestinal disordersNot knownDry throat56 more rows

What are 2 medications affected by nicotine?

The chemicals in smoke may interact with antipsychotics, antidepressants, benzodiazepines,8 oral contraceptives, inhaled corticosteroids and beta blockers via pharmacokinetic and pharmacodynamic (often nicotine-mediated) mechanisms.

Does nicotine patch affect your blood pressure?

The main conclusion was that none of the nicotine patches had any effect on heart rate or blood pressure, although urine epinephrine was increased.

What is the success rate of the nicotine patch?

The 12 month sustained success rates were: 25 mg patch for 22 weeks (L-25), 15.4%; 25 mg patch for 8 weeks (S-25), 15.9%; 15 mg patch for 22 weeks (L-15), 13.7%; 15 mg patch for 8 weeks (S-15), 11.7%; and placebo (P-0) 9.9% (placebo versus 15 mg, p<0.05; 25 mg versus 15 mg, p<0.03; 25 mg versus placebo, p<0.001, Chi- ...

Can nicotine patch cause heart palpitations?

Nicotine patches may cause palpitations and abnormal heart rate. Patches should be used with caution in patients who take medications for abnormal heart rhythm.

What contraindications are there to prescribing NRT?

Contraindications and cautionsDiabetes mellitus.Gastrointestinal disease.Phaeochromocytoma.Moderate to severe hepatic impairment.Severe renal impairment.Uncontrolled hyperthyroidism.History of epilepsy.

What are the side effects of nicotine replacement therapy?

Side effects of NRT can include:skin irritation when using patches.irritation of nose, throat or eyes when using a nasal spray.difficulty sleeping (insomnia), sometimes with vivid dreams.an upset stomach.dizziness.headaches.

Can nicotine lozenges harm you?

Using nicotine lozenges can also cause serious side effects that require a visit to your doctor, including: persistent throat irritation that gets increasingly worse. heart palpitations or irregular heartbeat (arrhythmia) issues with your teeth, gums, or other tissues in your mouth (like sores)

Are nicotine pouches safe?

There is no data to show nicotine pouches as a safe or effective way to quit. University Health Center medical experts and Nebraska Medicine certified tobacco treatment specialist Jill Selzle, PA, do not recommend these products.

Can nicotine patches cause heart palpitations?

Nicotine patches may cause palpitations and abnormal heart rate. Patches should be used with caution in patients who take medications for abnormal heart rhythm.

Can you take ibuprofen with a nicotine patch?

No interactions were found between ibuprofen and Nicorette. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.

What happens if you smoke a cigarette while on the patch?

You can also consider adding gum or lozenge, as described above. What if I slip up and smoke while using the patch? You do not need to stop using the patch if you slip up and smoke while wearing it. Throw away your cigarettes and get back on track with your quit attempt.

Does nicotine interfere with antidepressants?

Quitting Smoking and Vaping and Psychiatric Medications Fortunately, nicotine-replacement therapy does not interfere with antidepressant or antipsychotic medications.

Who should not take NICOTINE PATCH?

The following conditions are contraindicated with this drug. Check with your physician if you have any of the following:

Have you ever purchased nicotine PATCH patch, transdermal 24 hours?

This survey is being conducted by the WebMD marketing sciences department.

What is nicotine replacement therapy?

Nicotine replacement therapy. Nicotine replacement therapy is a treatment to help people stop smoking. It uses products that supply low doses of nicotine. These products do not contain many of the toxins found in smoke. The goal of therapy is to cut down on cravings for nicotine and ease the symptoms of nicotine withdrawal.

What are the different forms of nicotine replacement?

TYPES OF NICOTINE REPLACEMENT THERAPY. Nicotine supplements come in many forms: Gum. Inhalers. Lozenges. Nasal spray. Skin patch. All of these work well if they are used correctly.

What does a nicotine inhaler look like?

The nicotine inhaler looks like a plastic cigarette holder. It requires a prescription in the United States.

How long does it take for nicotine to peak?

The spray gives a quick dose of nicotine to satisfy a craving you are unable to ignore. Levels of nicotine peak within 5 to 10 minutes after using the spray. Follow your provider's instructions about how to use the spray.

How long does it take to replace nicotine patches?

All nicotine patches are placed and used in similar ways: A single patch is worn each day. It is replaced after 24 hours. Place the patch on different areas above the waist and below the neck each day. Put the patch on a hairless spot.

How long does it take to stop smoking gum?

People who smoke 25 or more cigarettes per day have better results with the 4 mg dose than with the 2 mg dose. The goal is to stop using the gum by 12 weeks. Talk with your doctor before using the gum for a longer period.

What to do if a child is exposed to nicotine?

Call the doctor or a poison control center right away if a child has been exposed to a nicotine replacement product, even for a short time.

How is nicotine absorbed?

Nicotine inhaled from cigarette smoke is easily absorbed over the large surface area of the lungs and is transported directly to the brain via the pulmonary venous system in 10–20 seconds ( 13 ). Nicotine levels reaching the brain fall quickly as nicotine is redistributed in the body, largely to skeletal muscle ( 12, 13 ). Nicotine replacement therapies from gum, lozenges, inhalers, and nasal sprays are absorbed through oral or nasal mucosa and go into systemic venous circulation. These forms cause nicotine levels to peak on the order of minutes, while transdermal patches release nicotine even more gradually with peak concentrations within hours after application ( 13 ). Swallowed nicotine is absorbed poorly in the acidic stomach environment ( 2 ). Some is absorbed in the small bowel and is carried into the portal venous circulation where it undergoes first-pass hepatic metabolism, resulting in low (30%–40%) bioavailability. Ingestion of nicotine replacement therapy by swallowing gum or lozenges is therefore not recommended, but rather through buccal absorption. Elimination of nicotine is highly variable from person to person, with an average half-life of approximately 2 hours, primarily by CYP2A6 ( 10, 13 ). Nicotine has varying addictive potential depending on the mechanism by which it is administered ( 10, 13 ). The FDA recognizes that nicotine delivered via gum, lozenges, and patches has little potential for abuse or dependence and has approved these forms for over-the-counter sale ( 14 ). The pharmacokinetics of inhalers and nasal sprays may make them more habit-forming than other nicotine replacement therapies but less so than smoking ( 13 ). Nicotine replacement therapies assist with smoking cessation by stabilizing nicotine levels in the blood, thereby reducing both the positive and negative reinforcing effects of faster-acting nicotine delivery mechanisms such as cigarettes.

What is the best way to quit smoking?

The United States Public Health Service recommends the use of nicotine replacement therapy , bupropion, varenicline, or a combination for all patients attempting to quit smoking, except when medically contraindicated or for populations in which insufficient evidence for efficacy exists (pregnant women, adolescents, and smokeless tobacco users) ( 7 ). Nicotine replacement therapy increases the success rate of smoking quit attempts by 50%–80% and demonstrates similar efficacy to bupropion and varenicline ( 19 – 21 ). Combination treatment with both nicotine replacement therapy and bupropion is more effective than monotherapy with either ( 19 ). The most effective type of therapy is a combination of the transdermal patch and a faster-acting form, such as the lozenge or gum, for breakthrough cravings ( 12, 21 ). Although varenicline is more effective than any single form of nicotine replacement therapy, combination nicotine treatment can be equally effective ( 20 ). Additionally, nicotine replacement therapy-assisted smoking reduction has the benefit of promoting abstinence among smokers who are not ready to quit at the time therapy is started ( 22, 23 ).

How long does it take for nicotine to reach the brain?

Nicotine inhaled from cigarette smoke is easily absorbed over the large surface area of the lungs and is transported directly to the brain via the pulmonary venous system in 10–20 seconds (13). Nicotine levels reaching the brain fall quickly as nicotine is redistributed in the body, largely to skeletal muscle (12, 13).

How long does smoking last?

The average lifespan of smokers is reduced by more than 10 years compared to individuals who have never smoked (2). Smoking cessation by age 40 reduces mortality by about 90% and cessation by age 60 reduces ...

How much does smoking cessation reduce mortality?

Smoking cessation by age 40 reduces mortality by about 90% and cessation by age 60 reduces the loss by 40% (2). Some studies have found improvements in symptoms of depression and anxiety from smoking cessation with effect sizes comparable to those for antidepressants (3).

Where is smoked nicotine absorbed?

Swallowed nicotine is absorbed poorly in the acidic stomach environment (2). Some is absorbed in the small bowel and is carried into the portal venous circulation where it undergoes first-pass hepatic metabolism, resulting in low (30%–40%) bioavailability.

Can you use nicotine replacement therapy for a smoker?

Nicotine replacement therapy can be used to alleviate the discomfort of nicotine withdrawal for individuals who are unable to smoke (e.g., while hospitalized). The importance of such symptomatic care is underlined by data showing that smokers with schizophrenia experiencing nicotine withdrawal in a psychiatric emergency department setting demonstrated less agitation when treated with therapy ( 24 ).

How to stop smoking after using nicotine patch?

Talk with your doctor. Tell your doctor if you have not been able to quit smoking after using nicotine patch for as long as it says to use it. The patch may have metal. Take off the patch before an MRI. If you have strange dreams or other trouble sleeping, take off the patch at bedtime.

What are some other side effects of Nicotine Patch?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

What do I need to tell my doctor BEFORE I take Nicotine Patch?

If you are allergic to nicotine patch; any part of nicotine patch; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.

What are some things I need to know or do while I take Nicotine Patch?

Tell all of your health care providers that you take nicotine patch. This includes your doctors, nurses, pharmacists, and dentists.

What to do if you swallow a nicotine patch?

If nicotine patch has been put in the mouth, call a doctor or poison control center right away. This medicine may cause harm or be deadly if used or swallowed by children or pets. If a child uses nicotine patch or if nicotine patch is swallowed by a child or pet, call a doctor or poison control center right away.

How many doses of a cigarette patch?

Follow all instructions closely. The patch comes in 3 doses. If you smoke 11 or more cigarettes a day start with the 21 mg patch (step 1). If you smoke 10 or less cigarettes a day start with the 14 mg patch (step 2). Put patch on clean, dry, healthy skin on the chest, back, belly, or upper arm.

Can you use a nicotine patch more than you told?

Do not use more than told. Unsafe side effects may happen. Tell your doctor if you are taking another drug to help you stop smoking. Avoid driving and doing other tasks or actions that call for you to be alert until you see how nicotine patch affects you.

How long does it take for nicotine withdrawal to start?

Symptoms of nicotine withdrawal generally start within 2 - 3 hours after the last tobacco use, and peak about 2 - 3 days later. Symptoms may be severe, depending on length and amount of tobacco use. Common symptoms include (1):

Is NRT safe for adults?

Nicotine use is low risk for most healthy adults and the goal of NRT is to remove the exposure to harmful combustion products while withdrawing from nicotine addiction. However, in some health conditions, nicotine itself poses or exacerbates health risks, particularly, cardiovascular. Additionally, NRT use has not been well studied in some patient populations such as adolescents, frail elderly, and pregnant and breastfeeding women. In these situations, additional considerations and cautions should be applied, but in many if not most cases, NRT can and should still be used if that presents less risk than the alternative of continued tobacco use.

What are some things I need to know or do while I take Nicotine Gum?

Tell all of your health care providers that you take nicotine gum. This includes your doctors, nurses, pharmacists, and dentists.

What do I need to tell my doctor BEFORE I take Nicotine Gum?

If you are allergic to nicotine gum; any part of nicotine gum; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.

What happens if you chew tobacco?

If you have any of these health problems: Chest pain or pressure, a heartbeat that does not feel normal, or a recent heart attack . If you still smoke, chew tobacco, or use other products that have nicotine while using nicotine gum. If you have temporomandibular joint (TMJ) disease.

How long does it take to smoke a cigarette?

Follow all instructions closely. The gum comes in 2 doses. If you smoke your first cigarette of the day within 30 minutes of waking use the 4 mg dose. If you smoke your first cigarette of the day more than 30 minutes after waking use the 2 mg dose. Use right after opening.

Can you take nicotine gum while pregnant?

You could have more side effects. This medicine may cause harm to the unborn baby if you take it while you are pregnant. If you are pregnant or you get pregnant while taking nicotine gum, call your doctor right away. Tell your doctor if you are breast-feeding.

Can you use nicotine gum more than you told?

Do not use more than told. Unsafe side effects may happen. Tell your doctor if you are taking another drug to help you stop smoking. Avoid driving and doing other tasks or actions that call for you to be alert until you see how nicotine gum affects you.

Can you stop smoking gum?

When you stop smoking, other drugs may be affected. Talk with your doctor. Tell your doctor if you have not been able to quit smoking after using nicotine gum for as long as it says to use it. Gum chewing may cause problems with dental work. If you are on a low-sodium or sodium-free diet, talk with your doctor.

Mechanism of Action and Pharmacokinetics

Drug-Drug Interactions

Indications and Efficacy

Adverse Effects